What is a Zoledronic Acid Infusion?

Zoledronic acid belongs to a group of medicines called bisphosphonates. It is used to treat Osteoporosis and Paget’s disease in women and men. A cannula will be placed in your arm and you will be given an Intravenous infusion of Zoledronate 5mg over at least 15 minutes, sometimes up to 30 minutes depending on the request from your doctor.

Benefits of Zoledronic Acid

Zoledronic acid is proven to:
– increase bone density in patients with osteoporosis.
– reduce fracture rates by 35 to 70%.
– reduce bone pain in patients with bone disease. i.e. Pagets disease of the bone

You must not be given Zoledronic Acid if:
– you are pregnant or breastfeeding
– allergic to bisphosphonates or any of the constituents of this medicine
– you have hypocalcaemia (the level of calcium in your blood is low)
– you have severe kidney problems

Side Effects of Zoledronic Acid
Some patients experience flu-like symptoms after the first treatment of zoledronic acid, but apart from this, side effects are not common. When considering zoledronic acid treatment, it is important to balance the small risk of side effects against the much greater risk of a major fracture.

Common Side effects
– Flu-like feelings – About 30% of people experience a flu-like feeling after their first treatment, which
usually lasts two to four days, but can occasionally go on for longer, sometimes with associated muscle
or joint aching. This problem is usually treated with regular paracetamol. The chance of this side effect
occurring after the second or third zoledronic acid infusion is much lower (about 3 to 4%).

Uncommon Side Effects
–  Kidney damage – People with severe pre-existing kidney damage can sometimes experience
deterioration in their kidney function after the administration of zoledronic acid. This is why it is important to drink extra fluid on the day of the infusion, and your doctor may advise you to stop taking any medication that can affect the kidneys. However, zoledronic acid is not normally given to people whose kidneys are not functioning well.

– Anterior uveitis, which is pain, swelling, redness of the eye. Contact your doctor if you develop any eye symptoms. It usually treated with steroid eye drops and resolves after a few weeks

Rare Side Effects
–  Osteonecrosis of the jaw (ulceration in tooth sockets or the gums) – This problem has been found in
cancer patients (where high doses of bisphosphonates are given) and, rarely, in people being treated for
osteoporosis. It is often associated with poor oral hygiene smoking and corticosteroid use. It mainly occurs following dental extractions. For this reason, it is suggested that the infusion is delayed until you have completed any major dental treatment.
It is also important to maintain good oral hygiene and have regular dental checks.

–  Thigh bone fractures – There is a very small risk of atypical leg fractures after longer-term use of
zoledronic acid infusions. (Usually more than 6 years). Contact your doctor if you experience pain, discomfort in your thigh, hip or groin as it may be an early sign of a pending fracture.

Preparation

• Ensure you have collected your bottle of Zoledronic Acid for your pharmacy and brought it with you to your appointment.
• Drink 2 large glasses of water 2 hours prior to your appointment
• Take 1g of paracetamol 1 hour prior to your infusion
• Ensure you have not had any tooth extractions, root canals or crowns in the last 3 months and no upcoming major dental work
• Bring your Medicare card
• Have the date of your last infusion (if known)